Textbook of Radiographic Positioning and Related Anatomy: Chapter 9 lumbar spine, sacrum, and coccyx, Flashcards

1. A portion of the lamina located between the superior and inferior
process is called the?

Pars interarticularis

2. The superior and inferior vertebral notches join together to form the?

Intervertebral foramina

3. Which radiographic position best demonstrates the intervertebral foramina?

Lateral position

4. The small foramina found in the sacrum are called?

Pelvic sacral foramina

5. The anterior and superior aspect of the sacrum that forms the
posterior wall of the pelvic inlet is called the?

promontory

6. What is another name for the sacral horns?

cornua

7. The sacroiliac joints lie at an oblique angle of? to the coronal plane

30 degrees

8. What is the formal term for the tail bone?

coccyx

9. What is the name for the superior broad aspect of the coccyx?

base

10. Classification, mobility, and movement type for Zygapopseal joint?

synovial, dIarthroidal, plane, or gliding

11. Classification, mobility, and movement type for Intervertebral Joints

cartilaginous, amphiarthrodial, no movement

12. List the specific joints or foramina that are demonstrated with
the LPO position

Left zygapophyseal joints

13. List the specific joints or foramina that are demonstrated with
the RAO position

Left zygapophyseal joints

14. List the specific joints or foramina that are demonstrated with
the Lateral position

Intervertebral foramina

15. List the specific joints or foramina that are demonstrated with
the RPO position

Right zygapophyseal joints

16. List the specific joints or foramina that are demonstrated with
the LAO position

Right zygapophyseal joints

17. The degree of obliquity required for an oblique projection at the
T12- L1 level is approximately

50 degrees

18 The L5-S1 level spine requires a ___ degree oblique

30 degrees

19. A ___ oblique is performed for the general lumbar spine.

45 degrees

20. ASIS is at what vertebral level

S1-S2

21. Xiphoid process is at what vertebral level

T9-T10

22. Lower costal margin is at what vertebral level

L2-L3

23. Iliac crest is at what vertebral level

L4-L5

24. Symphysis pubis is at what vertebral level

Tip of coccyx

25. True or False: The use of higher kV and lower mA seconds for a
lumbar spine improves contrast but increases patient dose?

FALSE

26. True or False: Placing a lead blocker mat behind the patient for
a lateral spine position improves image quality?

TRUE

27. True or False: Gonadal shielding should always be used for male
and female patients for studies of the lumbar, sacrum and coccyx.

FALSE

28. True or False: The anteroposterior (AP) projection of the lumbar
spine opens the intervertebral joint spaces better than the PA projection.

FALSE

29. True or False: The knees and hips should be extended for an AP
projection of the lumbar spine.

FALSE

30. True or False: An increased SID of 44 or 46 reduces distortion of
spine anatomy.

TRUE

31. True or False: The lead blocker mat and close collimation must
not be used when performing digital imaging or the lumbar spine.

FALSE

32. What is the best modality that demonstrates the pathological
features of osteoporosis

Bone densitometry

33. What is the best modality that demonstrates the pathological
features of soft tissues of lumbar spine

MRI

34. What is the best modality that demonstrates the pathological
features of structures within the subarachnoid space

MRI

35. What is the best modality that demonstrates the pathological
features of Inflammatory condition such as pagets disease

Nuclear Medicine

36. What is the best modality that demonstrates the pathological
features of compression fractures of the lumbar spine

CT

37. Lateral curvature of the vertebral column

scoliosis

38. Fracture of the vertebral body caused by hyperflexion force

Chance Fracture

39. Congenital defect in which the posterior elements of the
vertebral fail to unite.

Spina bifida

40. Most common at the L4-L5 level and may result in sciatica

Herniated nucleus pulposus

41. Forward displacement of one vertebra onto another vertebra

Spondylolisthesis

42. Inflammatory condition that is most common in males in their thirties

Ankylosing spondylitis

43. Dissolution and separation of the pars interarticularis

Spondylolysis

44. A type of fracture that rarely causes neurologic deficits

Compression fracture

45. CR is centered at the level of ____ for an AP and lateral lumbar
spine projections

Illiac crest

46. What two structures can be evaluated to determine whether
rotation is present on a radiograph of an AP projection of the lumbar spine?

Sacroiliac joints and Spinous process

47. How much rotation is required to properly visualize the
zygapophyseal joints at L5-S1?

30 degrees

48. What set of zygapophyseal joints is demonstrated with an LAO position?

Right (upside)

49. The _______ which is the eye of the "scottie dog"
should be near the center of the vertebral body on a correctly
obliqued lumbar spine?

Pedicle

50. Which positioning error has been committed if the "eye of
the scottie dog" are projected too far posterior with a 45
oblique position of the lumbar spine

excessive rotation

51. Which position or projection of the lumbar spine series best
demonstrates a possible compression fracture?

Lateral

52. A patient with a wide pelvis and narrow thorax may require a CR
angle of ___ with caudad or cephalad for a lateral position of the
lumbar spine

5 to 8 degress caudad

53. How should the spine of a patient with scoliosis be positioned
for a lateral position of the lumbar spine

With the sag or convexity of the spine closest to the IR

54. Why should the knees and hips be flexed for an AP lumbar spine projection?

Reduces lumbar curvature, which opens the intervertebral disk space

55. True or False: the female ovarian dose used for a PA lumbar spine
projection is approximately 30 percent less than the dose from an AP projection

TRUE

56. Where is the CR centered for a lateral L5-S1 projection of the
lumbar spine

1 1/2 inches inferior to the iliac crest and 2 inches posterior to ASIS

57. What amount of CR angle is required for an AP axial L5-S1
projection on a male patient.

30 degrees cephalad

58. True or False: PA or AP projection for a scoliosis series
frequently includes one erect and one recumbent position for comparison.

Ture

59. True or False: A PA projection for a scoliosis series produces
only about 1/10 the dose to the breasts as compared with the AP
projection, even if proper collimation is used.

TRUE

60. Which techniques or devices produce a more uniform density along
the vertebral column for an AP/PA scoliosis projection.

Compensation filter

61. Which side of the spine should be elevated for the second
exposure for the AP/PA projection scoliosis series (by having patient
stand on a block with one foot.

The convex side of the spine

62. During the AP (PA) right and left bending projections of the
lumbar spine, the ___ must remain stationary during positioning.

Pelvis

63. Which projections should be taken to evaluate flexibility
following spinal fusion surgery?

Hyperextension and hyperflexion projections

64. How much CR angle is required for an AP projection of the sacrum
for a typical male patient?

15 degrees cephalad

65. If a patient can not lie on his back for the AP sacrum because it
is too painful, what alternative projection can be taken to achieve a
similar view of the sacrum?

A PA with 15 degrees Caudad CR angle

66. Where is the CR for an AP projection of the coccyx.

2 inches superior to the pubis symphysis

67. True or False: The AP projection of the sacrum and coccyx can be
taken as one single projection to decrease gonadal dose.

FALSE

68. Patients should be asked to empty the urinary bladder before
performing which projection fo the vertebral column?

AP of sacrum and coccyx

69. In addition to good collimation, what should be done to minimize
overall "fogging" on a lateral lumbar spine or lateral
sacrum and coccyx radiograph

Place led blocker table top behind patient

70. Which SI joint is visualized with an RPO position

Left

71. How much rotation of the body is required for oblique position of
SI joints

25 to 30 degrees

72. What type of CR angle is recommended of the AP axial projection
of the SI joints on a female patient

35 cephalad

73. Where is the CR centered for an oblique projection of the SI joints.

1 inch medial from upside ASIS joint

74. A radiograph of an AP projection of the lumbar spine reveals that
the spinous processes are not midline to the vertebral column and
distortion of the vertebral bodies is present. Which positioning error
is present on this radiograph

rotation of the spine

75. A radiograph of an LPO projection of the lumbar spine reveals
that the downside pedicles and zygapophyseal joints are projected over
the anterior portion of the vertebral bodies. Which positioning error
is present on this radiograph

Insufficient rotation of the spine

76. A radiograph of a lateral projection of a female lumbar spine
reveals that the mid- to lower intervertebral joint spaces are not
open. The technologist supported the midsection of the spine with
sponges to straighten the spine. What else can be done to open the
joint spaces during the repeat exposure?

If the patient has a wide pelvis, CR can be angled 5 to 8 degrees caudad

77. A radiograph of a lateral L5-S1 projection reveals that the joint
space is not open. The technologist did support the middle aspect of
the spine with a sponge. What else can the technologist do to open up
the joint space during the repeated exposure?

Place additional support beneath the spine, or use a 5 to 8 degree
caudad angle

78. A radiograph of an AP axial coccyx reveals that the distal tip is
superimposed over the symphysis pubis. What must the technologist do
to eliminate this problem during the repeat exposure

Increase CR angle is required to separate the coccyx from the
symphysis pubis.

79 . A radiograph of an oblique position of the lumbar spine reveals
that the downside pedicle and zygapophyseal joint are posterior in
relation to the vertebral body. what modification of the position must
be made during the repeat exposure to produce a more diagnostic image

Decrease rotation of the body and spine.

80. A patient comes to the radiology department for a follow-up study
for a comparison fracture of L3. The radiologist requests that the
collimated projections be taken of L3. Which specific projections and
centering would provide a quality study of L3 and the intervertebral
joint spaces.

AP or PA and collimated lateral projections would provide the best
view. The CR should be about 2 inches above iliac crest.

81. A patient with injury to the coccyx enters the ER. When
attempting the AP projection, the patient complains that it is too
uncomfortable to lie on his back. He is unable to stand. What other
options are available to complete the study?

Perform PA rather than an AP projection and reverse the direction of
the CR from caudad to cephalad.

82. A patient with a clinical history of spondylolisthesis at the
L5-S1 level comes to the radiology department. Which specific lumbar
spine position is most diagnostic in demonstrating the extent of this condition?

A lateral postion would demonstrate the degree of forward displacement.

83. A positioning series for SI joints is performed on a patient. The
resultant radiographs do not demonstrate the inferior portion of the
joints. What can be done during the repeat exposure to demonstrate
this aspect of the SI joints

The CR should be angled 15 to 20 cephalad.

84. A patient comes into the radiology department for a lumbar spine
series. He has a clinical history of advanced spondylolysis. Which
specific projection of the lumbar spine series will best demonstrate
this condition

Although AP and lateral projections of the lumbar spine are helpful,
posterior or anterior oblique positions best demonstrate advanced
signs pf spondylolysis

85. A patient comes to the radiology department with a clinical
history of HNP, Which of the following imaging modalities provide the
most diagnostic study for this condition?

MRI

86. A patient comes to the radiology department for a lumbar spine
series. She has a clinical history of severe kyphosis. How should the
lumbar spine series be modified for this patient?

Routine lumbar spine projections should be performed erect.